Not so much back to back hard days, but what percent of your weekly TSS are you getting from a single day? I guess from what I was hearing, you are getting greater than 50% of your stress from those two hard rides and I was wondering if that can put you in a bad place overall stress wise.

I’m also a bigger athlete. I’ve struggled with Upper Respiratory issues and getting sick often. The only time I’ve gone a season without getting sick was when I was on Ketosis diet. I’ve definitely found that the more carbs I eat the more I get sick. But I really struggle with racing/training on a fat adapted diet. You often talk about your high carb intake. Not sure if you have ever tried reducing this in a concerted effort to remain healthy.

It may be worth trying TCM too, I did a long time ago and it (quite surprisingly) worked for me. I tried acupuncture but it didn’t work for me although I know it does for my brother in law. I also had great results with an Ayurvedic practitioner.
I really pooh-poohed the Ayurvedic stuff until I was at my wits end and my girlfriend practically forced me to try it and I really wish I had gone for it sooner.

I know these can both be seen as a bit airy fairy and what works for one may not for another but just more options for you.

Nate, I heard your issues on the podcast and read up on the forum, I feel for you as your medical history and current issues read a lot like my own a few years ago.

The fact that you had sinus surgery and have seen an ENT is good, however, the fact that you are still getting repeated sinus infections suggests that the problems have not been addressed. From my early teens (now 46) I had repeated sinus infections and had to rely on heavy and long doses of antibiotics to the point I had them on repeat prescription here in the UK for use as and when required. Eventually, I saw an ENT privately and had surgery to widen my sinus openings, reduce my turbinates and importantly remove a huge build up of polyps.

The CAT scan that I had of my head showed that although my sinus openings were not too bad my sinus cavities were effectively full of polyps that he believed were a result of repeated sinus infections and allergy symptoms, since the surgery (14 years ago) I had only two infections in the first year and none since.

Therefore, my initial thoughts would be CAT scan to check for polyps and see another ENT to further improve drainage.

However, my energy levels and fatigue, despite the resolution of the persistent low-level infection from my sinuses, come and goes. I never really get ill, however, exercise ultimately leaves me run down and tired. I am allergic to almost everything (no exaggeration) I even reacted to the control substance when having prick test i.e. distilled water as any allergic response makes me super sensitive to any other allergens.

I am seeing my doctor next to see if I have fibromyalgia as I ache all the time and have repeated episodes of fatigue.

See another ENT and get a CAT scan to stop the sinus infections first!

Are you familiar with Nourish Balance Thrive? They offer in-depth blood, hormone, stool, and metabolism testing and consultation. Their main focus is athletes. Doctor Tommy Wood is brilliant and they are driven to be on the cutting edge of the latest understanding of health, nutrition and performance. The founder is a competitive cyclist as well as others on the team. They have a terrific podcast as well with a deep dive into all aspects of wellness. Christopher Kelly (founder) lives near Santa Cruz.

As far as the IGIV goes, I think there is some risk involved. I had Guillan-Barre’ Syndrome (super scary and rare). Pretty much the only treatment that can help with that condition is IGIV. My Neurologist wanted to use IGIV as an absolute last resort effort if needed. Luckily I never got to the point where I was completely paralyzed and did not undergo IGIV therapy. I would definitely look at the risks if you feel that you need to go with IGIV.

I think an elimination diet might be a good thing to try. There are so many things that are impacted by what we eat without us even knowing it. From what I understand, allergy testing is far from conclusive and an elimination diet is the best way to confirm if there are issues with what you are eating. When I lived in So Cal I would get terrible allergies and was sick 3 times per year. I changed my diet and my allergies went away and I did not get sick for 2-1/2 years. The next time I did get sick it was really mild.

I wonder if you are taxing your pancreas? With all of the carbs you eat is your body working too hard to constantly create insulin? How’s the glycemic load of your diet? That takes into account the quantity as well as the quality.

My fiance’s aunt has an autoimmune disease and has been seeing a Functional Medicine Practitioner that has helped her a lot. We live in Sparks/Spanish Springs and I believe the person she is seeing practices in Incline. If you are interested you can message me and I can get you her information.

Yes, we do sound the same! If you discover anything more please update me, and I’ll do the same.

I’ve also wondered if my body is fighting a low level infection all the time and that’s why I get tired. Then, if I do too much I get super tired super easy. I just described it to my wife last night as being “fragile”.

I can do everything else “right” in my life by eating well and sleeping a ton and that helps the symptoms, but there’s still something causing all of this.

I’ve actually had two sinus surgeries. Between the two they did a CT and saw that the polyps were removed. My surgery went in the second time and further reduced my turbinates. I can actually breathe REALLY well out of my nose now and I feel I get good drainage. I’ve just had two sinus infections since then (August).

Thanks Monty. I’ll check out Nourish Balance Thrive, I like the idea of getting more data!

I wasn’t aware of bad stuff with IGIV (besides cost) so I will also look into that.

As far as elimination diet and allergies go, I find that mine are seasonal. If I eat really poorly they do flare up though.

So I think they are pollen based rather than food. For example if I go to Hawaii all of my allergies go away! It’s amazing!

And like today, as long as I’m not around cats/dogs I have zero allergies.

That being said, an elimination diet is on my long list of things to try if some of the higher up things on my list don’t work.

I’ve also only been doing the high carb thing for almost a year now. Before that I had a low carb diet and before that a traditional SAD American diet (pretty much, not super extreme but not “optimal”). On all of those I’ve had sinus infections.

I will take note of the Functional Medicine Practitioner. Right now my priorities are:

Local doctor

Mayo Clinic (probably the one in MN)

Then I feel like they will either find a root cause or suggest IGIV.

If they find a root cause and I can fix it, struggle over! If it’s IGIV time then I will probably look into other methods so I don’t have to do IGIV weekly/monthly for the next 70 years. I’d still start IGIV int he mean time.

Yep, I understand about the pollen. I told my friend (sister was a nutritionist) the same thing. I thought it was only the pollen. How could it be related to what I am eating? When I changed my eating the seasonal allergies went away. Worked for me but everyone is an individual.

I still suffer terrible fatigue and have all my life, other than the occasional high white blood cell count, when I’ve decided or been bad enough to go to the doctor’s office other blood tests have not diagnosed any underlying issues and I probably feel good 50% of the time and fatigued for the other 50%. Likewise, I’ve cut all alcohol, and meat free which I felt better for a few months, then the lethargy crept back in.

Hi Nate , I used to get sick a lot mixing weight lifting with Cycling, I found it was easy to get over stressed, as a result I switched to plyometrics at body weight and found this worked well with TR sessions , little and often🤘P

Sorry about the medical issues. Very cool to see you reaching out to the community for input.

My general thought is that you’ve done a great job demonstrating that traditional medical solutions and supplements are not working for you. Not sure how you can assess the impact of any of the many supplements/approaches you’re taking without a more controlled/systematic approach. I suggest giving all that a short break and trying something different.

I’m very curious to hear more details about your diet, specifically in regard to gluten, dairy, eggs, fish/shellfish, soy and nuts/tree nuts—these are the six foods that people are most allergic/sensitive to, and you may have some issues with more than one of these. Keep in mind, allergy testing does NOT conclusively show food sensitivities that can cause symptoms like fatigue and chronic conditions like eosinophilic esophagitis.

I’d consider cutting out all the supplements, and any medicines possible, and trying a 6-food elimination diet. It removes the six food groups listed above. Avoid processed foods, sugars, sulfites. Eat healthy fats, protein and complex carbs. Within six weeks, you’ll know if what you’re putting into your body is a contributing factor with the sluggishness/fatigue, My guess is that you’ll also see it reduces the infections.

Hi Nate - You didn’t by any chance get Glandular Fever when you were younger?

No, not that I know of.

Altoption:

I’d consider cutting out all the supplements, and any medicines possible, and trying a 6-food elimination diet. It removes the six food groups listed above. Avoid processed foods, sugars, sulfites. Eat healthy fats, protein and complex carbs. Within six weeks, you’ll know if what you’re putting into your body is a contributing factor with the sluggishness/fatigue, My guess is that you’ll also see it reduces the infections.

An elimination diet is on the list to try. My post might not be clear, but all the crazy supplements have only been a thing for about two weeks now. Before that, I was just Vitamin D3 and fish oil.

@carytb Interested where you are going with this? I did get Glandular Fever in my early 20s, and I’m in a very similar position to @Nate - is there a connection? (Nb might be one for a new thread so as to not hijack Nate)

@ThomDean Glandular Fever came to prominence this year in the cycling community due to the health problems that Mark Cavendish has been having. I believe that the Epstein -Barr virus is the one that causes Glandular Fever and my understanding is it never goes away once you have had it. In the majority of people this is never an issue however in some (like my sister in law) the theory is that seems to manifest itself in later life as ME which can cause all sorts of health problems. Disclaimer: I am not in any way anything to do with the medical profession. https://en.wikipedia.org/wiki/Infectious_mononucleosis